Provider Demographics
NPI:1407957368
Name:CULLMAN EYE SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:CULLMAN EYE SPECIALISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:CHE'
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-734-8514
Mailing Address - Street 1:601 GRAHAM STREET SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-5298
Mailing Address - Country:US
Mailing Address - Phone:256-734-8514
Mailing Address - Fax:256-734-8392
Practice Address - Street 1:601 GRAHAM STREET SW
Practice Address - Street 2:SUITE B
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5298
Practice Address - Country:US
Practice Address - Phone:256-734-8514
Practice Address - Fax:256-734-8392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-A13-TA-594152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529927530Medicaid
AL5684190002Medicare NSC
ALK798Medicare PIN